| NPI | 1295763217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI LAWRENCE Director Of Provider Enrollment 864-385-4790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-04-14 |